Somatostatin analog therapy in delaying progression of polycystic liver disease: A meta-analysis with trial sequential analysis

ABSTRACT Background Polycystic liver disease (PLD) can occur independently or in association with autosomal dominant polycystic kidney disease and has no effective medical therapy. This meta-analysis evaluated whether somatostatin analog therapy slows progression of PLD. Methods The PubMed, Scopus, Web of Science, and Cochrane databases were searched through to May 1, 2025 to identify randomized controlled trials that evaluated somatostatin analogs in PLD. The primary endpoints were percentage change from baseline in total liver volume (TLV), total kidney volume (TKV), and estimated glomerular filtration rate (eGFR). Safety endpoints included cholelithiasis, cholecystitis, diarrhea, and abdominal pain. Effect sizes were estimated using mean differences (MDs) and odds ratios (ORs) within a random-effects framework. Trial sequential analysis was performed for TLV, TKV, and eGFR. Results Seven randomized controlled trials with 640 participants were included. Somatostatin analog therapy led to a significant reduction in TLV (MD −6.73%, 95% CI −8.68 to −4.78; p